It is known in the art relating to dressings for indwelling catheter access sites to use protective bandage tape or clear film product alternatives that use non-sensitizing hypoallergenic adhesives to cover all or part of the indwelling catheter access sites. Some dressings combine non-woven tape and absorbent gauze-like materials which have skin-mating surfaces of non-adherent film to reduce the effect of adhesive stripping caused by the dressing removal. The absorbency and bacterial barrier of the pad typically varies minimally from one manufacturer to another, but this type of dressing is least occlusive to moisture vapor.
One known dressing system includes an opaque pad for adhesive placement over an access site and an adhesive strip, for adhesive securement to the skin of a patient under a catheter tube as it emerges from underneath the pad, and between the skin and the pad along the edges of the pad in opposite directions from the tube exit location.
In known prior art access site dressings, a side arm of an introducer sheath, which is usually at a 60 degree or 90 degree angle to the introducer sheath secured by the dressing, and other medical tubing and connectors, and stresses imparted thereto, can cause separation of the dressing from a patient's skin. For example, when a patient moves his or her head, the side arm or other tubing acts as a lever and tears loose the dressing. This is undesirable because a patient will often move his or her head and the dressing is ineffective if it releases from the patient's skin. Also, the side arm tends not to stay flat against a patient's body but instead projects or lifts up off the body, which further loosens the dressing.
Further, known prior art access site dressings have not been able to accommodate all of the potential combinations of medical tubing that can exist at an access site. For example, during open heart and/or thoracic surgery, an introducer sheath alone or an introducer sheath along with either a single, double, or triple lumen central venous catheters (CVC) may be present at an access site. Alternatively, there may be an introducer sheath in combination with a pulmonary artery catheter (PAC) (for example a Swan-Ganz or similar) or an introducer sheath in combination with a Swan-Ganz catheter along with either a single, double, or triple lumen CVC. Finally, after surgery in the operating room, the introducer sheath is usually removed within one to two days, but the CVC (either single, double, or triple lumen) may remain in the access site for up to seven or more days. The prior art dressings have been able to accommodate some of these combinations but no prior art dressing has been suitable for use with all of these possible combinations. Even those which do accommodate a few combinations often come loose from the skin within a day or less, and thus serve no useful clinical purpose.
Finally, for medical procedures involving an access site, either a right side or a left side access site may be used. It is preferable to use the right side access site, but in approximately 40% of the cases, it is necessary to use the left side access site. Prior art access site dressings are capable of being used on either the right hand side or the left hand side, however, they do not secure and protect the catheters and access sites, and come loose prematurely on either the left or right side.